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Background: Exudative retinal detachment without ocular metastasis is extremely rare.
Case presentation: We report a case of sudden onset of painless vision loss in the left eye with relative afferent pupillary defect. Fundus features suggested exudative retinal detachment. Abnormal cutaneous findings and lung findings led to the suspicion of malignancy. Computed tomography of the brain and orbit showed no ocular metastasis; however, imaging of thorax, abdomen and pelvis revealed lung malignancy with distant metastasis. Immunohistochemistry profile of the skin biopsy was suggestive of metastatic adenocarcinoma.
Conclusion: A high index of suspicion, thorough physical examination and prompt intervention can be lifesaving.